Critical Evaluation of Failure of Peripheral Intravenous Catheters

SONM Us e On ly2806 NRS Assessment 3, Trimester 1, 2019
Assessment 3: Critical Evaluation (2000 words)
Weighting 50 %
Due date: 17:00hrs May 13, 2019
Critical Evaluation Template (Do not submit this table template)
Introduction
PICO Complete this table
What is the
problem/population?
Failure of peripheral intravenous catheters
What is the
intervention?
the addition of skin glue to standard peripheral intravenous catheter
What is the
Comparator?
to use of skin glue or not
What is the primary
outcome?
peripheral intravenous catheter failure at 48 hours, irrespective of the cause
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SONM Us e On ly2806 NRS Assessment 3, Trimester 1, 2019
What are the
secondary
outcome/s?
The failure of the individual modes of a peripheral intravenous catheter such as
infection, phlebitis, dislodgement, or occlusion
Critical Appraisal
models
Critical Appraisal Skills Programme (CASP). (Critical Appraisal Skills
Programme, 2018)
Journal The journal of the Annals of Emergency Medicine is highly regarded because it
has monthly ISSN of 0196-0644 and E-ISSN of 1097-6760 (Clarivate Analytics,
n.d.).
The journal was published in Australia.
This implies the findings of the research are credible and can be relied upon for
decision making.
Authors the authors are experts in the field because all of them have attained masters level
and above, and have experience because they are attached to reputed hospitals.
Title, Abstract and Literature Review
A good journal article title should have the problem of investigation, the target
population, and the method of study (Orcher, 2016). The title of the research paper is
consistent with the text because it is in line with the study objective which is to
examine if the failure rate of peripheral intravenous catheters could be minimized by
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SONM Us e On ly2806 NRS Assessment 3, Trimester 1, 2019
the addition of skin glue to it. The significant features of an abstract include the study
objective, methods, results and conclusion, all of which are reflected in this research
study (Dewan & Gupta, 2016). The literature has also been cited in the background and
it’s relevant but brief.
Research Design
The research utilized nonblinded, randomized control trial quantitative type of study
design which belongs to the level I evidence (Balshem et al., 2011).
Does the addition of skin glue to the insertion site of the peripheral intravenous
catheters in the ED minimize the failure of the device at 48 hours?”
The research was significant because the most commonly used medical invasive device
in hospitals is the peripheral intravenous catheters. Approximately 80% of the all the
admitted patients undergo the medical insertion during their stay in the emergency
department (Limm, Fang, Dendle, Stuart, & Warburton, 2013; Zingg,& Pittet, 2009).
The study has hypothesized that the addition of skin glue to the site of insertion of the
peripheral intravenous catheters in the ED will minimize the rate of failure at 48 hours.
This is a scientific hypothesis (Javanmard & Montanari, 2014).
The participants were divided into two groups: the standard group (with standard
peripheral intravenous catheter securement) and skin glue group (with standard
peripheral intravenous catheter securement in addition to the skin glue at the insertion
site). Cloth-bordered transparent polyurethane dressing and tape was applied to the
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SONM Us e On ly2806 NRS Assessment 3, Trimester 1, 2019
patients in the standard group, whereas those in the skin glue group received one drop
of cyanoacrylate glue at the insertion site and one additional drop under the peripheral
intravenous catheter hub.
The sample
The population of interest comprised of patients who required hospital admission had
to be 18 years and above, had a patent upper limb peripheral intravenous catheter
inserted through intact skin by a healthcare provider
The research took place at Caboolture Hospital which is a community hospital located
in North of Brisbane. The hospital has 52,000 emergency presentations each year.
All eligible participants were screened by one of the three trained emergency research
nurses. The screening was done after ascertaining that a patient needed hospital
admission so as to differentiate from those being discharged from the emergency
department. The selected patients had to be aged 18 years and above had to have a
peripheral intravenous catheter inserted at a patent upper limb through a healthy skin
by an ED nurse or doctor. The researchers obtained ethical approval from the human
research ethics committee of the hospital.
Data collection
The study gathered data on patient and PIVC characteristics using patient
questionnaire and through observation. These included the age, mean, PIVC failure,
infection, phlebitis, dislodgement and occlusion. The primary outcome was measured
by the failure of the peripheral intravenous catheter at 48 hours, defined as a
combination of one or more of phlebitis, infection, dislodgement and occlusion. The
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